#829 - Dr Leah Lagos - How To Improve Your Heart Rate Variability

0:00What's the history of HIV who discovered it? It's really interesting. It originated being a metric that doctors looked at before babies were born to predict the vitality of the unborn baby that they would be healthy upon birth. And then in time, doctors began using it as a metric of cardiovascular health and other conditions at HIV is very much associated with clinical conditions from fibromyalgia to irritable bowel syndrome, to depression, to anxiety, and then a cohort, a small subset of people, including myself, came along and said, well, what about people that aren't afflicted by a condition, but just wanted to get better?

0:46And that question has been the last 17 years of my research and practice. Wow. So I think a lot of people listening will be familiar with HIV, what it is, and sort of the fundamentals, but just give us the 30 ,000 foot overview recap. Sure. So HIV has to do with the variability in between each heartbeat. And essentially the short, simple answer without getting too technical. and I think that's one of the things public has to understand people get lost in the science. Chris is that we are looking for bigger numbers for greater health and resilience. But everybody has a range. And so the scientific definition has to do with the oscillatory variability in between each heartbeat and measured in milliseconds.

1:39And that's the technical Good definition. What we'll talk about today is HIV in terms of RSA, Resonant, Sinus, Arrhythmia. And it's so much easier to understand and grasp as a user because you can look at with all sorts of different wearables that are out now, the peak to trough. So when you inhale your heart rate goes up and when you exhale, it goes down. And that phenomenon is known as Resonant, Sinus, Arrhythmia. And ultimately, we want that variation to be is bacon beautiful as possible, almost like ocean like waves. But that's not exactly what happens in life. We get stuck. There are stressors and we can talk about the different variables in time.

2:21But we want to optimize those oscillations to be resilient, adaptable, flexible, marked by agility to kind of respond as we need and acclimate flexibly. Is that what you mean by autonomic flexibility? It does. It does. And people think about stress in terms of am I stressed or am I not? But what we really should be talking about is your agility in handling it. How long does it last? Are you able to let it go when it happens? How long does it take you? Are there specific stressors that take you longer? And you begin to look at HIV and we can dive into this as deeply as you want, but as a metric that gives you insight about yourself.

3:11So of course we can train HIV and I'll take you through my protocol for doing that, which is in my book Heart Breath Mind. But I want the world to understand HIV is a measure of who they are, what amplifies them, what takes away from their natural gifts. and it's a metric that people can calibrate with breathing but also with study and research on what kind of leads to these changes in today. I have never heard anybody explain the adaptive reason for why HIV lowers when we are stressed. there must be an advantage that is given to the user for having a lower HIV under sympathetic arousal. What is that?

4:00It's likely associated with the reptilian response of a mobilization. Our body immobilizes it in prehistoric days to conserve energy. And while the reptilian response served a function and can serve a function in certain stress situations, usually it doesn't and it stays longer than you need. So that's so interesting. So your hypothesis is that when we were reptiles, we would need to, but why would surely, surely a high HIV, if we needed to lay out in the sun and warm ourselves on a rock, surely that would have allowed us to regain more energy than a low HIV, no? That would, lying on a rock and being in the sun, sunshine, the light exposure is what could enhance HIV.

4:58But the autonomic nervous system during times of stress wants to conserve energy and what it tends to do is fragment what I call autonomic bandwidth. So if you have an HIV, Chris, let's say, just you measure it with your orb being or other wearables and there are many and you have a range of 42 to 75. You begin to look at what's happening on different days to understand what's what's reducing your HIV and maybe it's things to date, maybe it's a conflict with a good friend. But what you're asking me is how could this have been adaptive for us? Yes. And my hypothesis would be in terms of trying to conserve energy and somehow keep the body safe in that way.

5:51However, we're in such a dynamic world that if we're a fraction of ourselves and the flexibility to respond is reduced, it doesn't work out that way. because we ruminate on the stressor for so long that we actually extend the stressor for a good amount of time. Yes. And that, for most people, is beyond conscious control. So the idea of just let it go is great, great idea, but then how do you do it? And I would argue that letting go is much more a physiological construct that can be taught through processes such as heart rate variability by a feedback training, than just, and I'm a psychologist by trade, then just cognitive techniques.

6:39But first, you have to teach the autonomic nervous system how to let go. Right. So you're suggesting that we go bottom up from the body to the mind, as opposed to top down, from the mind saying, hey, calm down, you're being too stressed. Why can't you just let go of this thing, which often makes you more stressed? So the other question that I have, what determines our range? You've mentioned that we have a range within which we sit. I know that one of your prescriptions will be your goal is to get to the top end of your range, so therefore comparing your HIV with somebody else's is kind of pointless.

7:11Unfortunately, I'm in a whoop group with some pro -athletes, some cricketers and some of their HRVs are in the 200s. So I'm always going to be bottom of the pile around them. But what is it that determines our range? There are a multitude of factors. There are biological pieces to this and low HRV. In some cases, can indicate a clinical condition. and they had that happen with clients where we've uncovered and properly gotten treatment and then worked on amplifying HIV as they went through other treatments. But it also can be chronic stress that's not properly managed. It can be a host of different pieces.

8:00There are also people that are more sensitive in this world and there are people that feel deeply, they connect quickly. I call them physiologically gifted, that in stressful moments, their heart rate reactivity may jump 30 beats, whereas someone else may jump 10. And that's not conscious. And that's not something that talk therapy is going to change. But they can increase the precision of their response under stress by having a stronger, what's called, a baro reflex gain. Through this process, the baro receptors control heart rate and blood pressure. And we gain control over that reactivity in the moment.

8:39It's it it's just calms and With that said there are many many different reasons people have Different levels of HIV I had one person it took us three sessions. I mean questions after questions I got it they were drinking 19 cups of coffee a day So sometimes the variables Chris are internal sometimes they're medical and sometimes they're external a big variable that people think about consciously that having a few glasses of alcohol, they know it impacts them, but they don't really have a sense of how sensitive their nervous system is or how long it lasts, but you can measure that. And so factors like sleep, alcohol use, lack of exercise, chronic stress can certainly dampen HIV, but they're not the only reasons.

9:32What does low HIV feel like, experientially, if it's acute? Let's say that you could just throw low HIV at someone that's listening now. What would that feel like in their body and their mind? Someone can't identify low HIV if that's their general baseline state. But some people can and we end we actually sometimes train this and from from my clinic with clients that are athletes on being able to recognize when when they have a lower HIV than a higher HIV when they wake up before they look at their scores just to develop their sense of somatical awareness and and being just aware of what their body is telling them and Some people will say when they are their HIV is on the lower end of the range that they feel more Myopic meaning their mind gets stuck more more irritable.

10:34They're less able to control their reactivity and they speed up faster But it's it's really different for each person and what's so fascinating is there's no one size, fits all, composite, HIV. This is exactly how you'll feel in low HIV versus high HIV. It's about really understanding the person, helping them be aware of what it feels like for them at the lower HIV and what it feels like at higher HIV and then understanding the factors that they can control to continue to amplify their HIV. Talk to me about the relationship between HIV, autonomic flexibility and the brain and brain function. So we used to think of heart rate variability, just as a metric of the autonomic nervous systems resilience to flexibly respond, which means if I need to amp up and run across the street, I can't.

11:31This isn't associated with relaxation or just being calm. It's acclimating or adapting flexibly to the needs of the moment. But then after I've run across the street and dealt with a specific need that caused me to run across the street, that I can return back to baseline quickly. And so for many years, HIV research really honed in and focused on HIV as a measure of adaptability and resilience. In the last 10 to 15 years, myself and several other researchers have focused on heart rate variability's impact on the brain and sure enough, this concept of oscillation. If we think of resonance, psysyrythmi, as that oscillation when you inhale your heart rate goes up, when you exhale it goes down and we want these oscillations to be as big as possible, we also want that oscillatory ability in our in our mind, right?

12:30To be able to focus on something deeply and let it go. It's a different style of oscillatory functioning, but conceptually, the ability to oscillate is what I call cognitive dexterity. And we're beginning to understand that heart rate variability is also indicative of someone's cognitive dexterity as well, meaning that someone can flexibly alter between a kind of deeply diving into a subject matter and then zooming out to consider contextual details or they're able to consider a lot of information and have a pause before they react. So there are different types of dexterity, but what can be really useful is the ability specifically and it's the first one that I work on with people that want the cognitive benefits associated with HIV is inhibition.

13:30So Chris, if there is something and everyone when you really dive deeply and someone's being authentic and open, everyone has a place in their life, they wish they had a little more control over before they act. And it could be work, it could be partnership, it could also be in a sports performance domain, but ultimately to have the ability to screen out negative thoughts and consider their desired behavior before they respond becomes a part of the cognitive process that they do gain control over. And this process HIV impacts the prefrontal lobe specifically. Wow. What about? So I understand that HIV is a metric which which is both acute and chronic or systemic.

14:24It's an indicator of where you're at now. And it's also an indicator of your sort of overall capacity, autonomic flexibility, probably health and fitness as well, stress response, and stuff like that. What is the relationship between heart health and HIV? Do healthier hearts always have a higher bet -cognc or better HIV? Yes. In fact, there's a wealth of research that suggests that low HIV is correlated with cardiovascular conditions. So we want that heart to have those large, abundant in oscillations, that variability is essentially associated with longevity and a longer life. So when I see people go through, in my clinic, 12 week training, many people stay for years after they say it's not just a change of heart, but a change of life.

15:25And we go through this process, but in the first 12 weeks, we often see the heart rate independent of physical activity, drop five beats. And so let's say your baseline heart rate is generally 65. It's now at 60. There is improved cardiovascular efficiency and certainly that is implications for heart health and longevity. How do you think about the difference between sort of hacking HIV in the moment so that you get the state change and long -term duration impacts on HIV, the trade change over time. Is there a difference between hacking and improving or do all of the hacks that improve in the short -term result in improvements in the long term?

16:14It's such a good question and I really am so glad you asked because people don't understand and that there are two different very distinct pathways for using HIV and focusing on HIV for different outcomes. So the first one is going through a process such as HIV training 10 to 12 weeks to increase heart rate variability baseline, meaning without even breathing. And why would you do that? What does it matter? Well, first of all, you want an autonomic nervous system that without even any conscious intervention can flexibly respond to the world. So people who are out in a boat have lots of meetings and go home to a family with lots of things happening will say, I just have more energy to manage the sensory inputs of the world require less from that nervous system because the nervous system is optimized.

17:11So that's one which is optimizing the baseline. How do we do that with the resonant frequency breathing And it really takes a minimum of 10 weeks, 15 minutes a day, twice a day, breathing at resident frequency, which I'll describe a little bit later. But what that does, Chris, is by week four, you have increased barereflex gain, meaning barereflex controls heart rate and blood pressure, and you've increased the mechanisms, the precision by which it senses and responds. It's just more precise. And I say to my clients, let's say you're a Volvo coming into my clinic, there's everything's going well, you get where you need to go, but now you've really increased to being more of a sports car where you can accelerate and decelerate just very quickly without expended more, expended energy.

18:03So that is the baseline piece. And then within the 10 weeks you continue to strengthen what's called barri reflex gain. And what happens is that the parasympathetic and the sympathetic nervous system in stressful situations, the sympathetic activation occurs. But now your parasympathetic, your parasympathetic dominant at baseline, and it comes quicker to bring down the sympathetic. The sensing is faster, and it allows you to let go, and this all happens underneath. You're not conscious of it. But you would just say to me, you know, let's say Chris, can you give me a stresser? Something just...

18:44Emails. Emails, and what about emails? When there's lots of them, and I need to reply. And so maybe you command an email, you know, the abundance of emails in every day is an e -dot of 10 stresser, and as you go through the process, the emails don't change. The emails have maybe even increased, but your reactivity to them, the feeling of stress towards them goes down a few numbers. And that has to do with the nervous system becoming more precise in your responding, meaning you can't even but, but you can let go faster. And I call it return to baseline. So that is the baseline piece. You would go through this process to increase your flexibility, agility, adaptability without without doing anything, it's a nervous system that is just more precise.

19:36And that's what the HIV training can do, one, improving baseline. Two is what I call HIV hacking and using wearables to calibrate your elite self. So you start to collect data. Okay, on Tuesday I was a 42 HIV on my, on my wearable, but on Sunday I was a 65. What's the difference? and you begin to target the variables and then define the algorithm through your own tracking to get a sense of what really helps calibrate you. And what's so fascinating is it's different for everybody. So when you really get to know somebody and look at the way they live their life, the way alcohol may impact you may be completely different from your neighbor.

20:25You may be someone that running three miles a day Really activates your parasympathetic nervous system in a beautiful way that shows up in your HIV calculation so but if you do it too many days it drops it so you start to really get a sense of who MI from a physiological perspective? Talk to me about the resonance breathing how this works the sort of pushing at the right time on the bike pedal I guess. So this process came about to me many years ago in the grad school at Recrease University. Paul Lear, who teaches at UMDNJ, was giving a presentation about his work with Afghani Vashilo and Barney Vashilo that he brought from Russia.

21:15They were they were working with Cosmonauts in Russia when they discovered something called resonance dinosauridmia. And it it essentially is a frequency that activates the entire nervous system and different what's called vagal afferent pathways. From the brain to the heart to the digestive track. When you activate this frequency, which is a specific frequency in the body, the numeric is .1 hertz, you activate multiple pathways at once and allowing them to tighten or strengthen than the homeostatic regulatory mechings. Okay, short, kind of short succinct way. He was using this at Rutgers and with the Vashilos to treat a multitude of health conditions with incredible outcomes, depression, PTSD, by my amyalgia, asthma.

22:14And so I went up to Dr. Lear and I said, have you used this with athletes? I interested in elite performance and that question led to the last two decades of my research in practice. And what we found is that specifically for athletes, this allows them to gain control over anxiety and being able to perform at what I call their full autonomic bandwidth or their elite itself. And so the HIV training takes approximately 10 weeks, meeting once per week, and identifying a rate of breathing that optimizes those beautiful heart rate oscillations. I have you practice that 15 minutes twice a day. The first four weeks, we work to maximize your baseline heart rate variability.

23:09And I look for what's called the Barrier Reflex gain, the indication around week four that your homeostatic mechanisms that control how you respond in the moment, how you anticipate a stressful moment and how you recover from a stressor are going to increase. And that's the first sign. And then sessions five through ten, I walk you through my protocol for managing stress more in the moment and being able to oscillate from a sympathetic to a So for people, let's say at the Olympics, they want to be able to create that parasympathetic state on demand in a certain number of breaths. We do that. A decision -maker for the UN will want to make sure that he or she is in a parasympathetic open agile receptive state where they can be very focused or contextually driven and they will want to learn how to reliably enter what you could call a flow state but I would scientifically call a parasympathetic state.

24:19So I tailor the training based on the needs of the individual but it is some modulation of physiological states to then control behavioral outcomes and even how they feel. Okay so as far as I'm aware about your process, there is a particular breath rate between five point, something and six point something. Yeah. So it's generally between five breaths per minute and six point five breaths per minute. Cool. So there is a particular rate, which is individual, it's individual for each person. When you find that, that helps based on the rate at which your heart beats and the way that it beats, the breathing in and the breathing out at that particular pace can help to amplify or getting it wrong to make worse your HIV, you're suggesting 15 minutes in the morning and 15 minutes in the evening, so twice a day and the first four weeks is you trying to basically dial in.

25:15What is that particular breath rate and then we sort of move forward from there? So, so almost that that was great and I love that explanation. So, generally in the first session, And we identify resonant frequency, that rate between 5 to 6 .5 breaths per minute. And then we do a little extra fixing on the side and helping to breathe from the abdomen on the breath. And also then learning to be able to inhibit other thoughts. And so there are pieces of this that I've I tailor in and I talk a little bit about in my book but to Activate the prefrontal lobe and one of the pieces since we're talking about HIV and the brain of it today is to make sure to use The pace that sets your resonant frequency if you close your eyes or listen to music You won't have the same cognitive effects when you look at a pacer matching your breathing to the pacer, it's a two -for -one a little bit, because you're optimizing oxygen and blood flow all over the body, especially to the prefrontal lobe while training attention.

26:32So it's maximizing the the cognitive enhancements. A pacer is just some sort of cue, maybe on a screen, something like that. Right. And there's several different ones on the iPhone and the Android if you just type in breath pacer, you can find the one you prefer. Some are just a line going up and down, some are balls that expand and contract. I have an app on a elite HRV that walks you through my 10 week protocol. You work on to use that if you like. There is many, but that watching the pace, or as you do your practice 15 minutes twice a day, does make a difference in terms of the cognitive impact.

27:10Okay. So you have this 15 minutes twice a day. Is the assumption from you methodologically that those 15 minutes sessions will begin to bleed into your breath rate outside of that session, getting closer to that. How long does it take? Because I breathe at whatever rate I breathe at, 6 .8 breaths per minute throughout the day on average. How long does it take to do two 15 minutes sessions a day to basically reprogram my breath rate? That seems like a very big change to come from only 30 minutes a day. So it does and you're absolutely right, it does become your habit, but what I'm really targeting is training your heart.

27:54So so that the rhythms, the resonant frequency rhythms are going to be different when you breathe. Let's say that first week at resonant frequency versus just your natural baseline. But I want the rhythms from your resonant frequency to be your baseline. And the heart is a muscle. Breath rhythms or heart rhythms. Heart rhythms. Okay, so you're training the heart more than you're training the breath during these 50 minute sessions, is that right? Correct. And subsequently, you train the breath after seven to eight weeks. But first and foremost, you train the heart. And by week four, I start to see the heart pattern that we, that I teach breathing at resident frequency to begin occurring just at their baseline.

28:40That's interesting. So how long or how much work is required after going through your protocol of 10, 12 weeks, how much work is required to maintain those gains afterward? If I stop after 10 weeks, do I just go back to normal? So you still have to do some breathing, not the same level, and what I recommend is to breathe three to four times a week, at least for 15 minutes. So it's kind of like calf raises in a sense, Chris. And once you get to a certain level of the muscle you wanted to develop, you don't have to push this hard to maintain it, but you do have to exercise it. People, it's not a perfect algorithm.

29:31People will say they are fine with twice a week, other people will say I just need to do one today five days a week. Other times I'll have people that will come back and just say, you know, the cognitive impact, the screen door effect where I can screen out what's not important and really focus on what is, is kind of waning after nine months. I want to just do a surge for another 10 weeks and we do. So, so if you notice the benefits minimizing, then the new up it and sometimes it's less maybe it's two weeks of going back to every day 15 minutes and you're feeling great again and then you tie trade so you don't have to breathe for the rest of your life for 15 minutes twice a day but you do have to do some breathing and I would just base it on how you're feeling and what you're needing to maintain.

30:22How should we be breathing throughout the day outside when we take it off the cushion? So to speak, what is your advice to your elite performance clients on what they should be doing and what they learn in week, whatever it was six to 10 or eight to 10? Yes, I love that question. I believe if we had everyone really understanding the powerful impacts of breathing, not only on how we feel, but how we make decisions and how we behave, we'd have a very different world. and there are ways to use the breathing to enhance health and so particularly moments that bring someone anxiety and then taking what I call a power 5, focusing just on that feeling of the crisp fresh air through the inhale and then letting go.

31:07That was a fear or the anxiety on the exhale to reset and they can take those small intervals as needed but there are also kind of fun ways to use this to enhance functioning other aspects of one's life. Parents might use this in terms of their own children and being able to flexibly respond to multiple children asking many needs at a time and before responding, taking a power of five or doing it with their kids altogether. And we should talk about that physiological connectivity is real and it's really amazing. But finding moments that you either want to have more control over how you're responding and be able to create a desired response or enhancing cognitive functioning, mental clarity, objectivity for decision making.

32:03Well, let's go into that. Explain to me, give me a couple of protocols and also I think importantly the cues of how people know to do the protocol. What are some of your favorites? What are the ones that give the most benefit? Sure. Many athletes, professional athletes, whether NBA or PGA tour will notice their mind racing. And it can be even something that something great that happens, a birdie on the golf course, but their mind races, the sympathetic arousal sets in and their mind is racing. And so as they're walking from whole to whole, they're practicing their breathing, counting four in six out to clear the mind and also return the body to their baseline.

32:52Four in six out. Correct. And what's interesting about adding the counting Chris is you can't count and think at the same time they require the same part of So for many people, the counting with the breath, and this is not for the 15 minute, twice a day practice, that's too much. But this is for kind of epic, epic of time uses to use the counting while they're taking a few breaths to quickly enter their desired base science state. Yeah, I guess anyone that's tried to do breath counting during meditation knows that you lose the count when you also lose your focus. It's very difficult to keep on top of that as you're going in and out.

33:35It's like playing music over the top of a sound that you don't want to hear. You can kind of really only hear one of them. The loudest sound at one time. Okay. What about... So, four in six out, longer on the exhale. What are some cues that you like to give people to remind them? Hey, this is something that you need to pay attention to. This is something that you haven't done yet today. So for some people they love being able to use this on demand if they have a racing mind or a heart rate that speeds up will identify physiological responses that would necessitate using let's say the power five to return to baseline.